Individual provider Active NPI

Lisa Michelle Tomasello, M.D.

  • Anesthesiology Physician
  • Detroit, MI
National Provider Identifier
1184834566
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301085824 Issued in MI
Practice address
Henry Ford Hospital
2799 W. Grand Boulevard
Detroit, MI 48202
Phone
(313) 916-4843
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301085824 MI Primary

Addresses

Primary practice location

Henry Ford Hospital
2799 W. Grand Boulevard
Detroit, MI 48202

Mailing address

1421 Chesapeake
Royal Oak, MI 48067-4505
Phone (954) 336-9296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090817000738 FL Practitioner - Anesthesiology 9436203056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

401 NW 42ND Ave
Plantation, FL 33317-2835
Phone (954) 587-5010

8201 W Broward Blvd
Plantation, FL 33324-2701
Phone (954) 476-3911

Hospital & facility affiliations

  • Westside Regional Medical Center Hospital, Plantation, FL, CCN 100228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301085824MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Anesthesiology CurrentSince Jul 1, 2009 Accepting new patients
Sheridan Healthcorp, Inc. Anesthesiology CurrentSince Jul 1, 2009 Accepting new patients
Sheridan Healthcorp Inc Anesthesiology Current Accepting new patients

Locations

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

8201 W Broward Blvd
Plantation, FL 33324
Phone (954) 476-3900

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184834566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 CHESAPEAKE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480674505",
            "telephone_number": "954-336-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HENRY FORD HOSPITAL",
            "address_2": "2799 W. GRAND BOULEVARD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMASELLO",
        "first_name": "LISA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301085824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.